Health Care Reform Brings New Options for Alzheimer’s Care

May 28, 2010

Little noticed in the new health care reform bill signed into law by President Obama in March is a provision that may provide help to families affected by Alzheimer’s disease. The provision, known as the CLASS Act, for Community Living Assistance for Services and Supports Plan, creates a nationwide voluntary insurance program to provide long-term care services and support to families affected by long-term ailments, including Alzheimer’s.

The insurance program will help people with Alzheimer’s to live at home and remain independent longer by providing benefits that can be used to pay for home care aides, transportation and respite care. While Alzheimer’s care is often much more expensive, the extra funds can help to pay for a family member or other home aide, for example, to help with dressing or bathing. CLASS funds could also help install a grab-bar or ramp in the home so that an elderly person with Alzheimer’s can stay at home longer.

People can also use their CLASS benefits for assistive devices, adult day programs, assisted living or nursing homes.

All working adults 18 or older can participate in the program. People will pay small monthly premiums through their employers, deducted from their paychecks. After five years, they are then eligible for home care benefits.

If a participant becomes disabled, through Alzheimer’s or any illness or accident, he or she is eligible for cash benefits of $50 to $100 a day to help pay for care, provided he or she has been in the program for at least five years.

Currently, many people cannot get any long-term care insurance at all. And many cannot afford it. It is estimated that fewer than 10 percent of older adults have bought long-term care policies.

Many families mistakenly believe that existing government programs like Medicare will provide financial assistance for an ill loved one living at home. But even though such care is less expensive than hospital or nursing home care, Medicare does not contribute to home expenses, though Medicaid does pay for some of these expenses for people who have run out of money. In many instances, family members must volunteer their time and efforts to help a loved one with Alzheimer’s.

The CLASS Act is a legacy of Senator Edward M. Kennedy, who died last year. The program is scheduled to take effect in Jan. 2011. Administrators are currently seeking to figure out how much premiums will cost, and how people might be able to participate if they are self-employed or if their employers decline to participate.

Among the unknowns is how many people will participate. The more younger and healthy people who do participate, the cheaper the program will be. Participation may be aided by the fact that all people who work for larger companies will automatically be enrolled in the program; individuals can opt out if they do not wish to participate.

Other features of the new health care law may also help certain families affected by Alzheimer’s.

People who have early-onset Alzheimer’s, a rare form of the disease that strikes before age 65, will now be able to purchase insurance. Insurers will no longer be able to deny coverage due to this pre-existing medical condition.

In addition, there will be new funds to study various pilot programs for delivering aid and care to Alzheimer’s patients in the coming years. Programs deemed successful for helping patients stay at home longer, for example, or for delivering care at lower costs can then be expanded.

By www.ALZinfo.org, The Alzheimer’s Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.